geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance


, : Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance. Plos One 10(6): E0127728-E0127728

Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new health technology pilot research can rapidly translate into policy change and scale-up. However, training, supervision and quality assurance models should be reviewed and strengthened as rollout of the Zambian RST programme continues.

US$19.90

PMID: 26030741

DOI: 10.1371/journal.pone.0127728


Other references

Volgareva, G.V.; Golovina, D.A.; Gasparjan, N.M.; Ermilova, V.D.; Pavlova, L.S.; Petrenko, A.A.; Fedorova, M.N.; Kurbatov, L.K.; Cheglakov, I.B.; Jarigin, K.N.; Kisseljov, F.L., 2007: STAT1 gene expression in cervical carcinomas. Expression of the STAT1 gene belonging to the group of interferon-regulated genes was analyzed in cervical tumors and cell lines harboring the genome of human papilloma viruses (HPV) of so-called high risk group. Expression of this gene in invasi...

Semb, L.S., 1965: Oxygen consumption of unstimulated gastric mcosa In relation to the secretion of hydrochloric acid and the number of parietal cells. Oxygen consumption (Q02 in [mu]l/mg h) was determined in gastric mucosal slices from 35 patients suffering from duodenal and gastric ulcers. The examination was performed simultaneously in 5 parallel slices with a modified Scholander respirometer....

Wan, Q.; Ni, L.; Wu, L.; Zhang, L.; Liu, M.; Jiang, X., 2016: The determination of sex type of the cultured murine cell with quantitative PCR technique. Human Cell 28(3): 154-157

Egan, F.; Barret, M.; O'Gara, F., 2014: The SPI-1-like Type III secretion system: more roles than you think. The type III secretion system (T3SS) is a protein delivery system which is involved in a wide spectrum of interactions, from mutualism to pathogenesis, between Gram negative bacteria and various eukaryotes, including plants, fungi, protozoa and ma...

Singh S.M.; Toles J.F.; Reaume J., 1986: Genotype associated and age associated in vivo cytogenetic alterations following mutagenic exposures in mice. We studied mice from eight genetic strains at two ages (young, 10 weeks; and old, more than 80 weeks) for cytogenetic alterations (sister chromatid exchange (SCE), micronulei, and metaphase indices) following changes by two known mutagens; N-nitro...

Benghuzzi, H.; Cason, Z.; Tucci, M.; Cameron, J.A.; Mohamed, A., 2011: Evaluation of the estrous cycle and ovarian function following sustained delivery of corticosteroid via tcpl delivery - biomed 2011. Stress has been shown to impair reproduction in many species and the hypothalamic pituitary axis (HPA) has been shown to be the target. Most of the literature evaluated the effects of acute stress and focused solely on the HPA. The literature is l...

Hirschfeld, G.; Sperfeld, A.D.; Kassubek, J.; Scharffetter-Kochanek, K.; Sunderkötter, C., 2006: Transient global amnesia (TGA) during an oral provocation test. After the oral administration of the COX 2 inhibitor rofecoxib (Vioxx) as part of an oral provocation test, a 64-year-old woman developed acute anterograde and retrograde amnesia which lasted for several hours. The patient did not show symptoms of...

Takahashi, S.; Sakai, S-Ichi.; Watanabe, I., 2006: An intercalibration study on organobromine compounds: Results on polybrominated diphenylethers and related dioxin-like compounds. An intercalibration study on organobromine compounds has been conducted to evaluate the accuracy and reliability in the analysis of brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and their related compounds like...

Fukagawa, M.; Inaba, M.; Yokoyama, K.; Shigematsu, T.; Ando, R.; Miyamoto, K-Ichi.; Yokoyama, K.; Shigamatsu, T.; Ando, R.; Miyamoto, K-Ichi., 2017: An introduction to CKD-MBD research: restart for the future. Clinical and Experimental Nephrology 21(Suppl 1): 1-3

D.L.ca, L.; Danchin, N.; Valgimigli, M.; Goldstein, P., 2015: Effectiveness of Pretreatment With Dual Oral Antiplatelet Therapy. Several observational studies, randomized controlled trials, and meta-analyses suggested that pretreatment with clopidogrel in addition to aspirin could reduce the rate of ischemic events, especially in the setting of acute coronary syndromes. New...